Minimally invasive surgery provides some significant advantages over open surgical procedures and as such, is being more frequently utilized. However, minimally invasive surgery and surgical techniques, for example, minimal incision surgery such as is utilized in spinal procedures, have created a special set of requirements with regard to the visualization of the operative field. These special requirements or changed parameters include the operative field being significantly reduced in size as compared to open surgical procedures. However, the depth parameter for the surgical procedure has remained unchanged. Therefore, the incision size to incision depth ratio has been markedly decreased very often geometrically creating unique challenges for the surgeon.
For example, unique geometry of the reduced size of the incision places severe constraints on the space available for the placement of surgical instruments in the area where the procedure is being performed. Visualization of the surgical area is also severely limited due to among other things, the size of the incision. As such, the size and number of surgical instruments that may be simultaneously used during minimally invasive surgical procedures is quite limited.
Additionally, minimally invasive surgical techniques typically require suction to be placed or located almost directly adjacent to the operative site. The proximity of the suction and visualization devices creates additional challenges relating to: design and material choice, and cost of manufacture/purchase. For example, especially when performing procedures with relatively small space constraints such as for example minimally invasive surgery, frequently requires the surgeon to utilize relatively high-speed abrasive rotating instruments. With relatively tight space constraints, this type of cutting tool may frequently come into contact with other surgical devices positioned within the surgical area. It is not uncommon for the other surgical devices to become damaged by this incidental contact. This can become quite costly for the hospital/surgeon to have to regularly repair and/or replace expensive surgical equipment in this manner.
A number of previous systems have attempted to address a few of these problems with limited success. For example, U.S. Pat. No. 5,588,952 (“Dandolu”) discloses a combination illumination and aspiration device. Dandolu further discloses that “reflector” is positioned at the tip of the device to diffuse and focus the emitted light from the side wall of the device. However, Dandolu fails to teach or suggest a system that focuses illuminating light ahead of the suction tip. Additionally, Dandolu is described as comprising stainless steel, which is undesirable because in tight operating environments, when a relatively high-speed abrasive rotating instrument comes into contact with surgical tools, particles can be produced, which cannot subsequently be removed from the surgical area. This is especially undesirable if the particles are metallic (e.g. stainless steel) because they may produce artifacts on post-operative imaging studies.
U.S. Pat. No. 4,872,837 (“Issalene et al.”) discloses an instrument capable of both illumination and aspiration. Issalene et al. further teaches use of a cannula having a beveled front end that may be used to concentrate and/or direct illuminating light in a controlled manner. However, Issalene et al. again fails to teach or suggest a system that focuses illuminating light at a point ahead of the suction tip. Rather, Issalene et al. teaches that the light may be directed off axis according to the beveled tip. Issalene et al. also fails to teach use of optical fibers, but rather uses the wall of the cannula itself to transmit the illuminating light. This may provide enough illuminating light for dental procedures, but would not be adequate, for example, for a minimally invasive surgical procedure.
U.S. Pat. No. 5,213,092 (“Uram”) discloses a combination aspiration and illumination/image guiding system. However, Uram positions the illuminating/image guides and aspiration tube side-by-side, which disadvantageously increases the overall size of the device. With minimally invasive surgical procedures, it is critical that the device remain a small in diameter as reasonably possible. Accordingly, Uram fails to teach a combination suction and illumination device that presents one concentric system to provide the smallest diameter possible. In addition, as the illumination guide is offset from the suction tube, Uram also fails to teach or suggest a system that focuses illuminating light at a point ahead of the suction tip.
Therefore, what is desired is a surgical system and method that provides for increased visualization in the surgical area while at the same time not further restricting the working area for the surgeon.
It is further desired to provide a surgical system and method that may effectively be utilized in connection with minimally invasive surgery that provides for increased visualization of the area where the surgical procedure is to be performed.
It is still further desired to provide a surgical system and method that minimizes the number of surgical tools that must be simultaneously inserted into the incision.
It is yet further desired to provide a surgical system and method that reduces the costs of suction and visualization tools.